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The aim of the study was to analyze morality, incidence of complications and influence of various prognostic factors on the outcome of patients with esophageal atresia. A retrospective analysis of the records of 109 consecutive cases of esophageal atresia and/or tracheoesophageal fistula operated in 1992-2001 was undertaken. Primary anastomosis was achieved in 68 (62.4%) patients, in 7 (6.4%) procedures aimed at esophageal substitution in future were performed and in 34 (31.2%) delayed anastomosis was primarily planned.Major associated anomalies were found in 55 (50.4%), cardiac anomalies in 19 (17.4%), and more than one associates anomaly in 16 (14.7%) patients. The most frequent surgical complication was anastomotic leak in 11.9%, septic complications were the most frequent and occurred in 66 (60.5%) patients. Gastroesophageal reflux was diagnosed in 30.3% and treated surgically in 14.7% of infants. The overall mortality was 20.2% (22 patients). The most frequent cause of death was sepsis and/or pneumonia. Long gap esophageal atresia was not found to be a significant factor in mortality. Factors significantly increasing mortality were birth weight below 2000g (OR 3.94), cardiac anomalies (OR 3.95), and mechanical ventilation before the operation (OR 2.97).Analysis of the outcome suggests that improved strategy in treating infants with multiple anomalies and more frequent attempts at primary anastomosis even in children in sub optimal general condition at diagnosis could decrease mortality.

To present incidences of the oesophageal atresia or stenosis and their maternal age distribution. To analyse maternal age as a possible risk factor for the defects studied.Retrospective epidemiological study.Institute for Care of Mother and Child, Prague, Czech Republic.Retrospective epidemiological study of oesophageal atresia and stenosis using data from the population based register of congenital malformations in the Czech Republic over the 1961-2000 period. The main source of data for this paper is the database of congenital anomalies at the Institute for Care of Mother and Child in Prague (the 1961-1990 period) and the data analysed by the Institute of Health Information and Statistics (the 1987-2000 period).Out of the total number of 5,589,888 births in the Czech Republic in 1961-2000 period, 804 cases of oesophageal atresia and stenosis were registered. Mean incidence of oesophageal atresia and stenosis in the period under the study was 1.51 per 10,000 livebirths. In the 1991-2000 period an increase of incidences of this congenital anomaly was revealed in the Czech Republic. By application of the two-sided 95% CI, statistically significant correlation was found in women of 39 years of age and older.Statistically significant increase of risk (for age as a risk factor) was found in maternal age groups of 39 years of age and over.

The paper deals with 10 years of experience a multispecialty team has reached in the therapy of tracheal stenoses and acquired tracheoesophageal fistulas. In 38 surgical patients the authors performed 50 reconstruction operations. The best results were reached in stenoses and tumours of trachea provided the patient had not died after the operation. In the group of 13 patients with surgery for tracheoesophageal fistula there were seven who died in the postoperation period. The problem of reoperation is discussed as well as the technique of the intervention with the use of Rehn's grafts and microsurgery occlusions of the fistulas by way of a tracheostoma. Two previously published cases are briefly described, the first being a complete resection of tracheal bifurcation, the other one being a rare mucosa form of epidermolysis bullosa, localized and surgically treated in the region of cervical oesophagus.